Key points

Key points

  • Inhaled corticosteroids (ICS) are the first-choice regular preventer therapy for adults, young people and children with asthma.

  • When long-acting beta agonists (LABAs) are prescribed for people with asthma, they should be prescribed with an ICS. LABAs should not be used without ICS.

  • Respiratory disease features in the NHS Long Term Plan published in January 2019.

  • Options for local implementation:

    • Review all people with asthma who have been prescribed a quantity of more than 12 short-acting reliever inhalers in the previous 12 months.

    • Monitor asthma control at every review. If control is suboptimal: confirm the person's adherence to prescribed treatment, review the person's inhaler technique, review if their treatment needs to be changed and ask about occupational asthma and/or other triggers, if relevant.

    • Adjust the dose of ICS over time, aiming for the lowest dose required for effective asthma control.

    • Consider decreasing maintenance therapy when a person's asthma has been controlled with their current maintenance therapy for at least 3 months.

    • Observe a person's inhaler technique and give advice when there is deterioration in their asthma control, when their inhaler device is changed, at every annual review, if the person asks for it, and at every consultation relating to an asthma attack in all care settings.

    • Offer a self-management programme, comprising a written personalised action plan and education to people with asthma.